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Cate Swannell
Med J Aust 2017; 207 (10): . || doi: 10.5694/mja17.n2011
Published online: 20 November 2017

Research at the University of Barcelona, published in PLOS Computational Biology, supports the view that multiple sclerosis, the symptoms and progression of which vary widely between patients, is nonetheless a single disease with consistent underlying mechanisms. Multiple sclerosis is an autoimmune disease that can cause a variety of problems, including blurred vision, impaired memory, and paralysis. Symptoms and patterns of disease progression over time vary among patients, leading to suggestions that it may consist of two or more different diseases. The researchers hypothesised that multiple sclerosis is a single disease with differing outcomes for different patients, but all driven by the same underlying biological mechanism: an immune system attack upon the protective sheaths around nerve cells, resulting in chronic inflammation and axonal degeneration. The researchers developed a mathematical model of multiple sclerosis based on experimental data from 66 patients who had been followed for up to 20 years. They used the model for computational simulations of the various biological processes known to be involved in the disease. To test the validity of their model, the investigators also ran simulations with data from a second group of 120 patients with multiple sclerosis. They found that changing the intensity of the underlying biological processes involved in multiple sclerosis at particular time points reproduced the variability of the disease courses seen in these patients. Their results support the hypothesis that the various symptoms and disease courses associated with multiple sclerosis are produced by the same underlying mechanisms. “This concept has significant therapeutic implications and will drive the development of new therapies because it implies that multiple sclerosis will produce significant disability if had for enough time in all patients,” says co-author Dr Pablo Villoslada. “Indeed, preventing relapses, although very important, will not be enough to achieve good control of the disease.”



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